This study investigates whether the supraorganizational accountability requests that healthcare organizations faced during and after the Covid-19 pandemic reduced or exacerbated the limited contribution of accounting information systems (AISs) to the clinical decision-making. A case study of an Italian university hospital was conducted through semi-structured interviews with clinicians and management accountants (MAs). The study seeks to investigate whether the organization responded to the accountability requests by aligning its AISs accordingly, or if it instead opted to modify the AISs to address clinicians’ decision-making needs. Both during and after Covid-19, the strengthening of supraorganizational requests affected the features of AISs, to the detriment of clinicians’ information needs, which remained largely unsatisfied. The study adopts institutional theory lenses and provides insights from clinicians and MAs on how the design of AISs to accommodate supraorganizational requests and related coercive isomorphic pressures limits decision-making at the clinical unit level.
Keywords: accounting information systems, accountability, Covid-19, clinicians, management accountants, healthcare
